My work brings me into a contact with a lot of folks related to the medical field, including executives at health insurance companies and managed care organizations. A few days ago, I interviewed a guy at an insurance company about a topic my client is interested in, and the discussion veered off course for a while to some talk about the recent election.
I can’t get into too many specifics here without risking my client’s interests, but let me just say this: We are in for a world of hurt when the ACA goes away. The insurance companies, which I thought might at least try to buck repeal on the basis of losing a ton of premium revenue from all those people dropping away from their plans, appear instead to be salivating over the cost reductions they are going to realize from:
- Offering fewer services (and making it harder to access the ones they do continue to offer)
- Drastically shrinking and restricting drug formularies
- Probable return to the days of rescission for reasons other than fraud or non-payment
- Removal of co-insurance and co-pay caps, and
- Rollback of lifetime payment limits
This guy said his company was absolutely giddy at the prospect. They don’t really even care if they lose premium dollars at this point, because the potential upsides are so great.
The real problem here is monthly premiums may drop somewhat as well, at least at first. So Obamacare critics will crow with delight that repeal of the law will have appeared to reduce insurance costs and how right they were all along about how the law affected pricing. But they also probably won’t realize their coverage has turned to shit and their out-of-pocket costs are going to soar, and if the GOP tries to keep popular provisions like coverage of pre-existing conditions and keeping kids on the plan until age 26 without the individual mandate, the cost of insurance premiums is quickly going to spiral out of control anyway. So we’ll be screwed both coming and going here.
This was just one guy at one company, and maybe other insurers are having different discussions right now, I don’t know. It’s not my place to ask unless the discussion goes in that direction organically, like this one did. But if, like me, you were hoping concern over the loss of premium dollars might get insurance companies involved in the fight to keep Obamacare, it appears such optimism may be misplaced.